What Is Frank’s Sign? And What Does It Say About Your Heart?

Do you have a diagonal crease on your earlobe? In some people, this seemingly harmless wrinkle may offer a clue about your heart health.

What Is Frank’s Sign?

Frank’s sign is a crease or wrinkle that runs diagonally across your earlobe, usually at about a 45-degree angle, says John D. Bisognano, MD, PhD, a cardiologist and a professor at the University of Michigan in Ann Arbor.

Who Is Frank?

Frank’s sign is named after Dr. Sanders T. Frank, who first described the crease in 1973 after noticing it in patients with angina, or chest pain caused by reduced blood flow to the heart.

Why Does Heart Health Affect the Earlobe?

Researchers don’t know for sure why an earlobe crease might be connected to heart health. But one leading theory is that it reflects changes in small blood vessels and the structure of the skin.

Because similar changes can happen in arteries, the crease may act as a visible clue to what’s happening in blood vessels elsewhere in the body.

“That area of the earlobe has a mixed blood supply, and it is possible that a mild lack of blood flow in that area suggests that there are other parts of the body — mainly, the heart — that also have similar lack of blood flow,” Dr. Bisognano says.

Does Frank’s Sign Really Matter?

It may, but it’s not a diagnostic tool, and experts don’t all agree on how useful it is.

“Realistically, this is not clinically used, and it is debated how truly associated it is with premature atherosclerosis,” says Abha Khandelwal, MD, a cardiologist and a clinical professor at Stanford Health Care in California.

“If a person has Frank’s sign, it probably does increase the probability of somebody having cardiovascular disease, although the data is pretty weak,” Bisognano says. “Our standard risk factors for heart disease provide a much more accurate prediction.”

What Should You Do if You Notice It?

If you notice a diagonal crease on your earlobe, there’s no need to panic. But it’s worth mentioning to your doctor or healthcare provider, particularly if you also have other heart-related risk factors.

“In the US, many people still have uncontrolled risk factors like high blood pressure, (high) cholesterol, (high) blood sugar, lack of exercise, and excess weight, and these are all far more important to focus on than an earlobe crease,” Dr. Khandelwal says.

You can reduce your risk by keeping up with routine screenings, taking any necessary medications, and making lifestyle changes. Though Frank’s sign is not especially meaningful, Bisognano says, it may still be a good idea to keep a watchful eye on heart health symptoms if you have the diagonal ear crease.

“Every piece of data is a potentially useful piece of data, and one need not ignore Frank’s sign as a risk predictor,” he says.

The Takeaway

• Since the 1970s, researchers have considered a crease in your earlobe — known as Frank’s sign — a potential marker for increased risk of heart disease.
• The crease may be the result of inflammation or stiffening of the arteries, which could be a sign of reduced blood flow in your heart.
• Although Frank’s sign alone is probably not a cause for concern, it may have a link to heart disease. Talk to your doctor about your heart-disease risk if you have high blood pressure, high cholesterol, or other risk factors.